By contributor Zoe Lauckner
Have you ever been out at sea alone for too long, seal hunting, and experienced intense panic-like symptoms and fear of drowning? Ever felt like your reproductive organs are disappearing inside your own body? In western society, we would likely categorize these behaviours to fit using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), likely diagnosing in the realm of anxiety or dissociative disorders. Among the Inuit peoples who have experienced kayak-angst, and people from Southeast Asia who have experienced koro, the concept of anxiety and dissociation doesn’t necessarily hold the same meaning.
Before we start to talk about culture-specific mental disorders, let’s delve briefly into the concept of social constructionism—that is the idea that we use to make sense of the world through shared assumptions about reality. These jointly constructed norms or assumptions are widely accepted by the society in which they were created, but may or may not represent a reality shared by those outside of the society of origin. What is normal in one society may not be normal in another, likewise with abnormality. For example, if you were to attend a church here in Nanaimo and in the middle of the sermon an attendee entered a trance-like state, speaking in tongues, that behaviour would likely be seen as abnormal and as a possible mental disorder. In other places in the world, even within North America, this behaviour is seen as quite normal and individuals experiencing this would be nurtured and supported throughout this journey. In fact, trance-like states are quite common around the world; in Nigeria, this is called vinvusa, and in Thailand, phiipob.
Additionally, in psychological research we are taught it’s important to understand the concept of reification, also called misplaced concreteness, which is when something that is abstract is treated as if it were a concrete, physical, and observable entity. Consider, then, the word mental—is this a construct or a concrete entity? We can’t measure it, we don’t know its shape or size, our understanding of the word is constructed through our society, which brings this conversation full circle back to social constructionism. Now that we’ve established that our understanding of mental illness is socially constructed and therefore varies widely across cultures, and that even the term mental is a construct, we’re left with curiosity.
To go back to our first point, kayak-angst is a condition historically traced to the Inuit of Greenland, specifically seal hunters who spend lengths of time in one-man boats. It is characterized by panic-like symptoms that include severe anxiety, rapid heartbeat, intense disorientation, helpless feelings, and fear of drowning. Treatment for this culture-related anxiety disorder is to get the hunter back on land and in the presence of other hunters. Frigophobia, also called pa-leng and wei han zheng, is a disorder well known to Chinese mental health practitioners, characterized by severe fear of wind and cold, which are believed to cause fatigue. These individuals will ruminate over loss of body heat and engage in avoidance behaviours related to the cold, such as wearing heavy clothing despite warm temperatures.
You’ve probably heard the term running amok before. One of the most interesting culture-specific disorders is called amok, which is characterized by a trance-like state in which individuals run compulsively, often brutally assaulting and sometimes killing people along the way. The western world was introduced to this disorder through the journals of Captain Cook, although historically it dates back as a Hindu war tactic. Amok is actually a Malaysian term meaning “to engage in furious battle,” where, following the rampage, the individual has no recollection of the episode. Although presentation and classification vary, this disorder is found across many different cultures, including the Inuit, where it is called pivloktoq, and the Navajo, called frenzy witchcraft.
Perhaps the most bizarre culture-bound disorder (from my western perspective) is koro, a Malay-Indonesian term meaning “turtle head.” This disorder is specific to males, and involves panic-like anxiety about the male reproductive organ sinking inside the abdomen and disappearing, which is thought to cause death. As is the case with many mental disorders in Asian countries, symptoms are often accompanied with somatic complaints, in this case involving the abdomen and genitals. Examples of this disorder are apparent in other parts of the world including Africa, Europe, and middle eastern countries.
It’s important to consider how our socially constructed understanding of mental disorders and illness impacts how we view, relate to, and treat those with mental illness. Preoccupation with constructed mental disorders can create a worldview that then informs treatment policy that is oriented towards the “disease” rather than the unique needs of individuals. Labels are seductive—in that they are simple ways for us to communicate about mental illness and form a shared understanding. However, behind every label is a person that is more complex than the diagnostic terms we use to define them.
Stay sane(ish), VIU. Until next time…